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Title: Seasonal asthma in Melbourne, Australia, and some observations on the occurrence of thunderstorm asthma and its predictability.
Austin Authors: Silver, Jeremy D;Sutherland, Michael F;Johnston, Fay H;Lampugnani, Edwin R;McCarthy, Michael A;Jacobs, Stephanie J;Pezza, Alexandre B;Newbigin, Edward J
Affiliation: School of Earth Sciences, University of Melbourne, Parkville, Victoria, Australia
Institute of Breathing and Sleep, Heidelberg, Victoria, Australia
Austin Health, Heidelberg, Victoria, Australia
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
School of Earth, Atmosphere & Environment, Monash University, Clayton, Victoria, Australia
Greater Wellington Regional Council, Pipitea, Wellington, New Zealand
School of Geography, Environment and Earth Sciences, Victoria University of Wellington, Wellington, New Zealand
Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
Issue Date: 2018 2018
Publication information: PLoS One 2018; 13(4): e0194929
Abstract: We examine the seasonality of asthma-related hospital admissions in Melbourne, Australia, in particular the contribution and predictability of episodic thunderstorm asthma. Using a time-series ecological approach based on asthma admissions to Melbourne metropolitan hospitals, we identified seasonal peaks in asthma admissions that were centred in late February, June and mid-November. These peaks were most likely due to the return to school, winter viral infections and seasonal allergies, respectively. We performed non-linear statistical regression to predict daily admission rates as functions of the seasonal cycle, weather conditions, reported thunderstorms, pollen counts and air quality. Important predictor variables were the seasonal cycle and mean relative humidity in the preceding two weeks, with higher humidity associated with higher asthma admissions. Although various attempts were made to model asthma admissions, none of the models explained substantially more variation above that associated with the annual cycle. We also identified a list of high asthma admissions days (HAADs). Most HAADs fell in the late-February return-to-school peak and the November allergy peak, with the latter containing the greatest number of daily admissions. Many HAADs in the spring allergy peak may represent episodes of thunderstorm asthma, as they were associated with rainfall, thunderstorms, high ambient grass pollen levels and high humidity, a finding that suggests thunderstorm asthma is a recurrent phenomenon in Melbourne that occurs roughly once per five years. The rarity of thunderstorm asthma events makes prediction challenging, underscoring the importance of maintaining high standards of asthma management, both for patients and health professionals, especially during late spring and early summer.
DOI: 10.1371/journal.pone.0194929
ORCID: 0000-0003-1502-6249
PubMed URL: 29649224
Type: Journal Article
Appears in Collections:Journal articles

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